The elves have noticed that psychological interventions are on the rise in many areas of physiotherapy. For example, self-management of musculoskeletal conditions may include both physical and psychological interventions.
The aim of a recent systematic review was to review musculoskeletal physiotherapists’ perceptions and use of psychological interventions, and review how skilled they felt to use these interventions within their practice.
Here’s what they did
The authors searched for qualitative, quantitative or mixed methodology studies published between 2002-2013 in AMED, CINAHL, EMBASE, MEDLINE and PsychINFO. Studies were included which focussed on physiotherapists’ perceptions regarding their use of psychological interventions within musculoskeletal physiotherapy out-patient departments.
Only papers published in English were included. All papers included were appraised using the Critical Appraisal Skills Programme (CASP) tool by 3 reviewers.
Here’s what they found
- 6 studies were included, qualitative methods (n=3), survey methods (n=2) and mixed methods (n=1), all presented with low levels of bias
- Physiotherapists frequently encountered psychological symptoms amongst patients undergoing rehabilitation including anxiety, depression and fear
- Psychological interventions commonly used included goal setting, positive self-talk, effective communication and variations in rehabilitation exercises
- All of the studies found that physiotherapists would like to improve their ability to implement realistic goal setting
- Physiotherapists in 4 studies reported feeling that they received insufficient psychological training during their undergraduate physiotherapy degree programmes
- There was great variability regarding the undergraduate training of physiotherapists
The authors concluded
While physiotherapists already use psychological interventions in their practice, for patients to reach their full potential, physiotherapists need to develop their skills to effectively incorporate psychological interventions.
The Musculoskeletal Elf’s view
While physiotherapists appear to have embedded Yellow Flag assessment tools within their practice, to identify psychosocial factors which may act as barriers to recovery, it is positive to see that physiotherapists are now using psychological interventions to address some of these aspects. It does seem essential though that this should also be included in undergraduate training programmes. To ensure standardisation of the teaching of psychological interventions this would require a review of pre-registration physiotherapy training programmes.
What do you think?
- How much training did you receive in your undergraduate programme about psychological interventions?
- How confident do you feel about addressing psychological symptoms in patients?
Send us your views on this blog and become part of the ever expanding Musculoskeletal Elf community. Post your comment below, or get in touch via social media (Facebook, Twitter, LinkedIn, Google+).
- Musculoskeletal physiotherapists’ use of psychological interventions: A systematic review of therapists’ perceptions and practice. Alexanders J, Anderson A, Henderson S, Physiotherapy [abstract]
- Early identification and management of psychological risk factors (“yellow flags”) in patients with low back pain: a reappraisal. Nicholas, M. K., Linton, S. J., Watson, P. J., & Main, C. J. (2011). Physical therapy. [abstract]
RT @MSK_Elf: Musculoskeletal physiotherapists’ views and use of psychological interventions http://t.co/QGBeJwky39
Musculoskeletal physiotherapists’ views and use of psychological interventions http://t.co/05z2c3ylaG via @sharethis
How confident do you feel about addressing patients psychological symptoms http://t.co/FWn7eVK8Ns @theCSP @physioMACP
patients #psychological symptoms how confident are you? http://t.co/FWn7eVK8Ns @PTHSN @PTThinkTank
Q. are you aware of tools for #psychological symptoms http://t.co/FWn7eVK8Ns @PhysioTalk @PhysiotherapyNZ
How confident do you feel about addressing patients psychological symptoms http://t.co/6B3r1VeTSE @Physiowizz @physioCan
Q. are you aware of tools for #psychological symptoms http://t.co/6B3r1VeTSE @WeAHPs @physiopedia
Interesting website @Physiopedia.
how can we better link physio community to psych interventions esp imp for chronic pain @lawtonrebecca http://t.co/skMLoI9t5S
I am currently pursuing an MSc (post registration) in physiotherapy in Glasgow Caledonian University, having no prior knowledge of the flags but I am now well equipped based on my current training and I can confidently identify and address though not all, some psychosocial symptoms in my patients.
@MSK_Elf @thecsp @PhysioMACP doing some research on this at the mo. Will keep you updated.
Look forward to it @c_hebron. What are you investigating? #nosy_elf